Table 4. Factors associated with mortality in patients with COPD and pneumonia: univariate analysis.
| Variable | Patients with COPD who died [n = 72], n (%) | Patients with COPD and alive [n = 911], n (%) | p value |
| Demographic data | |||
| Age, median (IQR), years | 80 (73–85) | 74 (66–80) | <0.001 |
| >65 years old | 65 (91.5) | 719 (79) | 0.011 |
| Male sex | 64 (88.9) | 825 (90.7) | 0.621 |
| Current smoker | 15 (21.4) | 236 (26) | 0.477 |
| Influenza vaccine (season) | 35 (64.8) | 592 (71.8) | 0.268 |
| Pneumococcal vaccine, 5 years1 | 8 (15.4) | 218 (27.6) | 0.054 |
| Chronic oral steroids | 16 (22.9) | 86 (9.5) | <0.001 |
| Statin use | 4 (17.4) | 85 (26.4) | 0.340 |
| COPD data | |||
| COPD stages III or IV | 8 (42.1) | 158 (29) | 0.220 |
| Chronic oxygen therapy | 4 (10.5) | 104 (14.9) | 0.462 |
| Inhaled steroids | 21 (56.8) | 401 (58.3) | 0.854 |
| FEV1, median (IQR), % | 41 (31.5–57.5) | 49 (36–62) | 0.279 |
| Comorbid conditions | |||
| Diabetes mellitus | 14 (19.4) | 202 (22.2) | 0.587 |
| Chronic heart disease | 25 (34.7) | 239 (26.3) | 0.119 |
| Neoplastic disease | 7 (9.7) | 105 (11.5) | 0.641 |
| Chronic renal disease | 12 (16.7) | 55 (6) | 0.001 |
| Dementia | 8 (11) | 30 (3.3) | 0.001 |
| Clinical features at presentation | |||
| Septic shock | 14 (19.4) | 53 (5.8) | <0.001 |
| Multilobar pneumonia | 32 (45.1) | 223 (24.6) | <0.001 |
| Bacteremia | 14 (20.6) | 71 (8.1) | 0.001 |
| High-risk PSI classes n (%)2 | 69 (95.8) | 650 (71.7) | <0.001 |
| Etiology | |||
| Streptococcus pneumoniae | 21 (29.2) | 337 (37) | 0.182 |
| Legionella pneumophila | 1 (1.4) | 20 (2.2) | 0.648 |
| Haemophilus influenzae | 7 (9.7) | 90 (9.9) | 0.963 |
| Aspiration pneumonia | 7 (9.7) | 42 (4.6) | 0.055 |
| Gram-negative bacilli | 14 (19.4) | 24 (2.6) | <0.001 |
| Pseudomonas aeruginosa | 13 (18.1) | 20 (2.2) | <0.001 |
| Atypical agents | 2 (2.8) | 16 (1.8) | 0.535 |
| Other organisms | 2 (2.8) | 27 (3) | 0.927 |
| Antibiotic therapy and outcomes | |||
| Inappropriate empirical treatment | 10 (13.9) | 33 (3.6) | 0.01 |
| Mechanical ventilation | 17 (23.9) | 26 (2.9) | <0.001 |
| ICU admission | 21 (29.6) | 48 (5.3) | <0.001 |
| Cardiac complications | 18 (25.4) | 55 (6) | <0.001 |
| Acute renal complications | 15 (21.1) | 20 (2.2) | <0.001 |
| Metabolic complications | 7 (9.9) | 21 (2.3) | <0.001 |
| Nosocomial infection | 4 (5.6) | 16 (1.8) | 0.026 |
DM, diabetes mellitus; FEV1: Forced expiratory volume in the first second; ICU: Intensive care unit; IQR, interquartile range; PSI, pneumonia severity index.
1
Data available only for 52 patients and 790 patients respectively; 2Patients were stratified into the following risk classes according to the PSI score: low risk (≤90 points, classes I, II, and III) and high risk (>90 points, classes IV and V).